| Skin Care | | | Prolonged pressure on the skin and the underlying tissue causes it to lose condition. If the pressure is not relieved the skin can break down, producing a pressure sore.
If not treated, pressure sores can ulcerate, leading to a medical emergency and prolonged hospital stay.
The risk is reduced by using pressure-relieving mattresses and cushions, and by the person shifting off his weight, or being turned if he cannot move independently
| | Because your blood flows more slowly after SCI, your healing ability is reduced. In addition, your skin cannot tolerate as much pressure as before. Your skin can now tolerate a minute amount of pressure for a long time, but it can only tolerate great pressure for a short time before the circulatory system is disrupted and a pressure or skin sore results. |
The decrease in circulation and lower tolerance for pressure is further aggravated by the lack of sensation after SCI. This lack of sensation means there is no longer a feedback mechanism to tell you that there is a problem - that you have been sitting too long without moving or that you have injured yourself, for example.
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The major causes of skin sores are: | • Prolonged pressure
• Bruises or scrapes
• Prolonged wetness on the skin
• Burns
• Sitting or lying on hard objects
• Frostbite
• Poor nutrition
• Clothing, braces, splints that are too tight
• Friction to the skin, caused by sliding or being pulled across a surface |
Prevention of Skin Sores: Body Check | | | In order to prevent skin sores, you must:
· Check your whole body frequently
· Relieve skin pressure
· Take routine care of your skin
Check your whole body, but pay special attention to bony areas by inspecting your skin at least twice daily. Morning and evening body checks when dressing or undressing is recommended. You can spot a problem at the very beginning. Checking your skin is your responsibility and the way to spot the warning signals of a problem. Don't just ask someone else how your skin looks. If you need someone to help you check, you must be able to tell him or her what to look for. Use a long-handled mirror to help you see your skin. If you need help, ask someone to position mirrors for you - one at the head and one over the pressure point.
Watch for any areas previously broken and healed over - scar tissue breaks easily.
You are looking for: Redness, blisters, opening in skin, rashes, etc. Feel for heat in red areas with the back of your fingers.
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How To Relieve Skin Pressure In A Wheelchair | | | Weight Shifts:
Weight shifts are the most essential techniques for preventing pressure on the skin and muscle of the sacrum (tailbone) and each hip. Use the method you and your therapists have found to be the most effective for you. Know your skin tolerance at all times. The frequency with which you do weight shifts vary from time to time.
Cushions:
A cushion for your wheelchair is essential. Cushions provide pressure relief and weight distribution and thus aid in the prevention of pressure sores. Many types of cushions exist, but there is no "ideal" cushion. Use the cushion recommended by your physical therapist/physiatrist. |
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